Ask The Experts: The Truth About Black Women, Hair Loss and Hiding It With Weaves

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A Houston-based doctor on a mission to help Black women properly diagnosis the cause of their hair loss, explains why hiding the problem will only make it worse.

Not every Black woman is rocking a fierce wig or weave just because she’s in the mood for something new – many suffer from such severe hair loss and balding that they have no choice but to hide it.

People often assume that wearing too many wigs or weaves is the culprit when younger women start balding in patches, but there are medical conditions like Folliculitis Induced Alopecia than can also be to blame. This condition occurs when bacteria goes down into the scalp, causes inflammation of the hair follicles, destroys them and makes it difficult for hair to grow back. Houston-based dermatologist Dr. Milton Moore is passionate about helping the Black women in his community battle hair loss and created the Moore Unique Skincare line to do just that. He says many of his clients are silently going bald, hiding it from their loved ones and just covering it up with weaves or wigs because they fear there’s nothing more that they can do. Because of this, he says, their self-esteem is suffering. Moore offers advice for these women and reveals the harsh realities of hair loss among sisters. What are the signs of Folliculitis Induced Alopecia?
MOORE: Folliculitis Induced Alopecia happens when a bacterial infection of the follicles cause hair loss. Can a dermatologist help?
MOORE: Yes, they can. My goal is to educate many of them on exactly how to treat tis type of alopecia in Black women – many just don’t know how to manage it. Is the hair loss damage permanent?
MOORE: A certain amount of the loss is permanent if not treated before the follicle is replace with scar tissue. If the follicle is still there, then I can get it to start producing hair again. Do wearing wigs/weaves do more than just mask the problem? 
MOORE: Yes. Doing so allows that person suffering from this to make believe they don’t have a problem in the public eye, but meanwhile the condition worsens. Weaves are the biggest problem because they cause traction on the hair and inflammation of the root of the follicle. Tenderness is a sign that there is inflammation and possible infection. Wigs raise the temperature of the scalp, and if there is an underlying problem, it can add to the low-grade bacterial infection. There is also a problem with demodex folliculorum, which is a natural mite contaminant in the scalp but can proliferate and induce inflammation. Anti bacterial topical agents can reduce the colony. There is also sometimes a problem with a proliferation of pityrosporum ovale, which is also a resident micro flora of the piloserbaceous hair unit. I put all of my patients on a 3-day course of anti-fungal medication called fluconazole. Can you talk a bit more about the self-esteem issue you’ve seen with your patients?
MOORE: Hair is a woman’s glory, and if it’s damaged or unhealthy looking, their self-esteem suffers also. Several of my patients state that their husbands are not aware of their massive hair loss because they don’t take their wigs or weaves off in front of them. They wear a head scarf to bed or sleep in the wig. There is some shame involved when a peron’s appearance is less than acceptable to them. What are the biggest no-nos as far as wigs/weaves when it comes to women who suffer from Folliculitis Induced Alopecia?
MOORE: Putting their weaves in too tight to make the time longer before they have to come in for a touch up. Wigs should not be worn all day and night.  Scalps need air to allow the scalp temperature to normalize. Is a dermatologist the only one who can spot this condition?
MOORE: A hair stylist should be able to at least tell the customer she is losing hair and there is redness or puss coming from the scalp. What’s the main message you hope to get across to women about this condition?
MOORE: This is a preventable and treatable condition when properly addressed early on. I plan to educated non-Black dermatologists about how to treat this condition effectively.

For more information about Moore’s Moore Unique Sking Care line and to ask more questions about diagnosing Folliculitis Induced Alopecia, visit:

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Filed under: Hair, Weave